Fleberismis a pathological condition characterized by a change in the structure of the venous system, leading to an increase in the diameter of the lumen of the superficial veins and a violation of the valvular system, resulting in valvular insufficiency, i. e. in their incomplete closure of the vein.
Normally, blood flows through the veins against the force of gravity - from the bottom up, which is possible only thanks to the work of the venous valves. Under the influence of a number of reasons, primary (due to changes in the valve itself) or secondary (due to expansion of the vein) valvular insufficiency occurs; this condition is characterized by incomplete closure of the venous valve and reverse blood flow. The reverse flow of blood worsens the changes in the venous wall, and also contributes to the stagnation of blood in the lower extremities, causing swelling of the lower extremities and a feeling of heaviness in the legs.
In addition to the stagnation of blood in the lower extremities, the above processes lead to a violation of the linear flow of blood through the veins from top to bottom, the appearance of reflux (reverse blood flow) and turbulent blood flows in the area of expansion. Changes in blood flow characteristics are the leading cause of thrombosis.
Possible reasons for the development of varicose veins of the lower extremities
- Physical inactivity- a leading cause of varicose veins. A sedentary lifestyle and prolonged sitting contribute to a long-term high load on the venous valves. During physical activity - walking, running, swimming - the constantly working muscles of the thigh and the lower part of the leg help to "throw away" the blood from the venous system of the lower extremities. Static sitting in a sitting position for a long time leads to an increased load on the venousvalves, and over time, venous valves, unable to withstand the load, may cease to perform their function completely.
- obesityshould be considered the second most important reason. Heavy weight also increases the load on the valve system of the veins of the lower limbs, which contributes to the disruption of their proper functioning.
- Pregnancyis the third most common cause. Hormonal changes, increased body weight, compression of the pelvic veins by the fetus are sufficient causes of venous valve dysfunction. However, up to 50% of changes in the venous wall detected during pregnancy are functional in nature and disappear on their own during the first year after birth.
- Smoking– the fourth most common cause of varicose veins. Changes in the venous wall may be related to the adverse effect of the composition of smoking mixtures on the tone of the venous wall.
- Heredity– another possible reason for the development of varicose veins. It is generally accepted that heredity plays a leading role in the development of varicose veins, but the genes responsible for the development of varicose veins have not yet been discovered; it is generally accepted that genes responsible for changes in the structure of connective tissue structures are a leading cause of varicose veins. However, the influence of heredity can be greatly exaggerated, and lifestyle changes, normalization of body weight and smoking cessation will help to avoid varicose veins even in patients with an unfavorable hereditary history.
Signs of varicose veins
- Presence of dilated saphenous veins, the nonlinear course of the vein is the most objective, but not the only, manifestation of varicose veins. Often, even veins dilated several times may not be visible, especially with a pronounced subcutaneous layer.
- Edema of the lower extremitiesat the end of the working day, especially with asymmetric swelling, are the earliest and most common sign of varicose veins.
- You should also consider the presence of varicose veins whenheaviness in the legsevening and night, leg cramps at night.
- Spider veins and venous patternintradermal veins, although they are more of an aesthetic problem, can also indicate the presence of changes in the saphenous veins.
- Constant redness, thickening of the skin, lipodermatosclerosis, trophic ulcers of the legs and feet indicate a decompensated course of varicose veins.
Diagnosis of varicose veins
The diagnosis of varicose veins of the lower extremities can be made only on the basis of data from ultrasound diagnostics.
During an ultrasound scan of the veins of the lower extremities, the doctor examines in detail the characteristics of the deep and superficial veins from the groin to the ankle, measures the diameter of the veins, analyzes the characteristics of the blood flow in the veins and detects the presence of reflux. Based on the data obtained, the doctor draws a conclusion.
Prevention of varicose veins
The prevention of varicose veins is a rational exercise regimen, normalization of body weight and smoking cessation.
If there are initial signs of varicose veins, venotonics and wearing compression stockings will help reduce the rate of progression of the disease.
Compression hosiery should be selected by a doctor depending on the severity of varicose veins and the anthropometric data of the patient.
Treatment of varicose veins
The treatment of varicose veins is exclusively surgical.
Currently, many different methods of surgical treatment have been developed - from open techniques - combined phlebectomy to minimally invasive methods - laser or radiofrequency coagulation of veins, mechanochemical methods.
- Varicose veins can be removed by miniphlebectomy, a technique in which the varicose veins are removed from the subcutaneous tissue through separate punctures and tied.
- Small varicose veins can be removed with the help of sclerotherapy - the introduction of a special glue-like substance - a sclerosant - into the venous lumens.
- Spider veins and intradermal veins can be removed by sclerotherapy.
However, even after complete treatment, the risk of recurrence of varicose veins of the lower extremities is 10-15%. Adequate physical activity, playing sports (running, walking, bicycle ergometer, swimming), normalizing body weight and giving up bad habits will help reduce the likelihood of recurrence after surgical treatment. Periodic use of phlebotonics and wearing properly selected compression stockings will help reduce the rate of spread.
The main thing is not to delay the visit to the doctor!